Pulmonary Autograft Mitral Valve Replacement (Ross II): Long-Term Follow-Up of a US Center

David Blitzer, Jeremy L. Herrmann, John Brown

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Mitral valve replacement (MVR) with a pulmonary autograft (Ross II) may be a useful technique for pediatric and young adult patients who wish to avoid anticoagulation. Our aim was to evaluate the long-term outcomes of the Ross II procedure at our institution.

METHODS: Patients undergoing the Ross II procedure between June 2002 and April 2008 were included. Preoperative diagnoses included rheumatic disease (n = 5), congenital mitral valve (MV) pathology (partial atrioventricular canal defect [n = 2], complete atrioventricular canal defect [n = 1], Shone's complex [n = 1]), and myocarditis (n = 1).

RESULTS: Ten patients (eight females and two males) between 7 months and 46 years were included. Mean age at surgery was 25.2 ± 15.7 years. There were no in-hospital deaths. Mean follow-up was 11.7 ± 5.2 years. There were three late deaths at 11 months, 5 years, and 11 years, respectively. Causes of death included right heart failure, sepsis, and sudden cardiac arrest. Three patients required subsequent mechanical MVR a median of two years after the Ross II procedure (range: 1-4 years). There was no mortality with reoperation. Echocardiographic follow-up demonstrated mean MV gradients ranging from 2.2 to 9.6 mm Hg. Two patients had greater than mild MV regurgitation postoperatively, and all others had minimal mitral regurgitation or less. Two patients developed moderate MV stenosis.

CONCLUSIONS: The Ross II procedure is an option for select older children and young adults desiring a durable tissue MVR to avoid long-term anticoagulation.

Original languageEnglish (US)
Pages (from-to)645-650
Number of pages6
JournalWorld journal for pediatric & congenital heart surgery
Volume9
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

Autografts
Mitral Valve
Lung
Mitral Valve Insufficiency
Young Adult
Mitral Valve Stenosis
Sudden Cardiac Death
Myocarditis
Rheumatic Diseases
Reoperation
Cause of Death
Sepsis
Heart Failure
Pediatrics
Pathology
Mortality

Keywords

  • autograft
  • congenital heart surgery
  • mitral valve
  • mitral valve replacement
  • Ross operation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pulmonary Autograft Mitral Valve Replacement (Ross II) : Long-Term Follow-Up of a US Center. / Blitzer, David; Herrmann, Jeremy L.; Brown, John.

In: World journal for pediatric & congenital heart surgery, Vol. 9, No. 6, 01.11.2018, p. 645-650.

Research output: Contribution to journalArticle

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